Is 24-Hour Urine Aldo a Good Test for Hypertension?

The Filtrate:

Joel Topf

Swapnil Hiremath

Samira Farouk

Matt Sparks

Jordy Cohen

And special guests:

Brian Byrd, a cardiologist investigating aldosteronism at the University of Michigan

and

Susan Steigerwalt, a nephrologist and hypertension specialist who unfortunately due to technical problems largely was cut out of this episode 😢.

The Study: The Unrecognized Prevalence of Primary Aldosteronism

Coverage at NephJC: http://www.nephjc.com/news/aldosterone

“What gets measured, gets managed.” Peter Drucker, or not

How much sodium comes from the food processing? 71%. Fourteen percent comes from the food itself, with 5% coming from food prep at home and another 5% from the salt shaker at the table. https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.116.024446

Surgical versus medical therapy for primary hyperaldosteronism: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.10596 .

And the editorial by David Calhoun: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.10759

I could find no empiric data to support Swap’s supposition that the French and Italian people are more courageous than people in Canada. Citation needed.

ENAC inhibitors as treatment for primary hyperaldosteronism: https://onlinelibrary.wiley.com/doi/full/10.1111/jch.13566

Pathway 3 Trial: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(15)00377-0/fulltext

Rennin in cow stomachs: http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/rennin.html

Sodium content of muffins: https://www.fatsecret.com/calories-nutrition/food/muffins/sodium

The MICE Package in R: MICE: Multivariate Imputation via Chained Equations) https://www.analyticsvidhya.com/blog/2016/03/tutorial-powerful-packages-imputing-missing-values/

Gender-Affirming Hormone Therapy, Vascular Health and Cardiovascular Disease in Transgender Adults https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13080

False-positive aldosterone renin ratios in patients on combined estrogen progesterone treatment (only with direct renin concentration, the plasma renin activity is not fooled) https://academic.oup.com/jcem/article/102/7/2329/3093639

John Funder video commentary on the study: https://www.acpjournals.org/doi/abs/10.7326/M20-1758

ACD blood pressure guidelines (note the absence of B): https://pubmed.ncbi.nlm.nih.gov/17083059/

Pathway 2 study: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/fulltext

ALLHAT trial: https://pubmed.ncbi.nlm.nih.gov/12479763/international.org/article/S0085-2538(20)30552-4/abstract